Provider Demographics
NPI:1437108115
Name:FERGUSON, CHINENYE UGORJI (RDH)
Entity Type:Individual
Prefix:
First Name:CHINENYE
Middle Name:UGORJI
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:MS
Other - First Name:CHINENYE
Other - Middle Name:ANNA
Other - Last Name:UGORJI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:58 BRACLAKIN RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-3819
Mailing Address - Country:US
Mailing Address - Phone:912-321-9887
Mailing Address - Fax:
Practice Address - Street 1:WORRIOR TRANSITION BATTALION, HHC, BUILDING 4970, RM235
Practice Address - Street 2:
Practice Address - City:FORT STEWART
Practice Address - State:GA
Practice Address - Zip Code:31314
Practice Address - Country:US
Practice Address - Phone:912-321-9887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11420124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1180709661OtherDOD